Begging the question

What is the point of an independent body recommending dentists’ pay, when we all know what the outcome will be anyway, Phil McCafferty asks.

The term ‘begging the question’ is often misused, but essentially it is a form of circular reasoning where one assumes the conclusion of an argument from the outset.

The Doctors’ and Dentists’ Review Body (DDRB) is tasked with setting the rate of pay for doctors and dentists in the NHS. It was set up 46 years ago, during the government of Edward Heath, shortly after the introduction of decimalisation or ‘new money’ as it was then commonly known.

Sadly, I have to admit I am ancient enough to remember old currency, much mourned by the typical Brexiteer, along with pounds and ounces and corporal punishment I remember the romance of the old thruppenny bit, which was the denomination of choice for football fans to hurl at referees. It had a lovely flight, being both heavy and compact due to its thickness of nearly an eighth of an inch, a mass of about a quarter ounce and it had 12 corners, so the impact was more telling than a rounder coin. And as you were only throwing away a quarter of a shilling, it was jolly good value to boot. The pound coin just can’t compete. Just two of them and you’re almost down the price of a pie these days.

And while we’re on the subject of ‘new money’, if you’re hoping for some, you can forget it, guys. The cupboard is bare. We all know that, and it begs the question from me: ‘Why do we have to endure the charade that is the Doctors’ and Dentists’ Review Body every year when we already know what its outcome will be?’

State of independence?

The DDRB was established as an independent body, however since the public sector pay freeze imposed in 2010 and the 1% cap announced in 2012, this so-called independent body has by a strange coincidence announced net pay rises of no more than 1% in each of these years. The public sector unions protest that this pay squeeze has resulted in a cumulative 15% pay cut in real terms for workers in the public sector. In NHS dental practice in Scotland, the effect is a cut of more than double that figure.

Any notion that this body is in any way independent of government policy is laughable. Every year the profession, via organisations such as the BDA, go to the trouble of compiling a comprehensive report for submission to the DDRB, at great cost to its members, only to suffer the perennial indignity of this cold shouldering by the government’s abettors.

It is pointless protesting at the injustice of it all. The public think we’re all loaded, and we’re the guys that hurt them and then take their money off them. A bit like the bully in the school playground taking their dinner money. They don’t care if our businesses are becoming increasingly unsustainable. The government bean counters are only looking at the global budget of a service they have flooded with dentists. The impact this has had on individual practices is of no interest to them.

This year the government at least appeared to be making some effort to gather this information itself by cutting out the middleman, undertaking its own analysis of the accounts of Scottish dental practices providing NHS general dental services. This exercise was carried out by a major accountancy firm, and although the results were not in the end very meaningful due to the low participation rate by NHS practices, they did at least demonstrate a pattern of flatlining of turnover and decreasing profits across the sample of practices that did participate. The reason for this, of course, is the inexorable rise in the cost of running a dental practice.

The word on the street is this that the accountancy exercise didn’t quite give the government the results they were looking for, in that it backed up the story coming from the profession that we’re heading for a crisis once more in NHS dentistry. With another independence referendum now on the horizon, the last thing they want is trouble. I suspect, unless they take heed of the coming storm as practices fight to survive, they could do worse than take our plight a little more seriously.